Guideline-directed medical therapy including sacubitril/valsartan and dapagliflozin significantly reduced clinically relevant atrial and ventricular arrhythmias in patients with a failing systemic right ventricle (p=0.027).
Cohort (n=46)
No
Does guideline-directed medical therapy including sacubitril/valsartan and dapagliflozin reduce arrhythmic events in adult congenital heart disease patients with a failing systemic right ventricle?
In patients with adult congenital heart disease and a failing systemic right ventricle, treatment with sacubitril/valsartan and dapagliflozin may reduce the incidence of clinically relevant arrhythmias.
p-value: p=0.027
Background/Objectives: Angiotensin receptor neprilysin inhibitor (ARNI) and sodium-glucose co-transporter 2 inhibitors (SGLT2i) are essential medications in heart failure (HF) therapy, and their potential antiarrhythmic effects have been reported. Recently, ARNI and SGLT2i use for HF in adult congenital heart disease (ACHD) has been studied. However, whether any beneficial effects may be achieved on the arrhythmic burden in the complex population of ACHD with a systemic right ventricle (sRV) is still to be determined. Methods: We retrospectively collected all significant arrhythmic events from a cohort of patients with a failing sRV attending our tertiary care center on optimal guideline-directed medical therapy (GDMT) with ARNI and/or SGLT2i. Results: A total of 46 patients (mean age 38.2 ± 10.7 years, 58% male) on sacubitril/valsartan were included. Twenty-three (50%) patients were also started on dapagliflozin. After a median follow-up of 36 Q1–Q3: 34–38 months, arrhythmic events occurred globally in 13 (28%) patients. Survival analysis showed significant reduction of clinically relevant atrial and ventricular arrhythmia at follow-up (p = 0.027). Conclusions: Our findings suggest that GDMT including sacubitril/valsartan and dapagliflozin may also offer an antiarrhythmic effect in ACHD patients with a failing sRV, by reducing the incidence of arrhythmic events at follow-up.
Ciriello et al. (Mon,) conducted a cohort in Failing systemic right ventricle in adult congenital heart disease (n=46). Sacubitril/valsartan and dapagliflozin was evaluated on Clinically relevant atrial and ventricular arrhythmia (p=0.027). Guideline-directed medical therapy including sacubitril/valsartan and dapagliflozin significantly reduced clinically relevant atrial and ventricular arrhythmias in patients with a failing systemic right ventricle (p=0.027).
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